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Utilization Review Nurse at LanceSoft, Inc.

Remote: 
Full Remote
Work from: 
Michigan (USA)

Offer summary

Qualifications:

Active MI RN License, Utilization management experience, Knowledge of InterQual criteria, Clinical knowledge relative to patient care, Certification in Case Management.

Key responsabilities:

  • Review post-acute care for transitions
  • Coordinate care activities and discharge planning
LanceSoft, Inc. logo
LanceSoft, Inc. XLarge https://www.lancesoft.com/
1001 - 5000 Employees
See more LanceSoft, Inc. offers

Job description

Job Description: 
  • This position will be remote role for Nurses in Michigan
  • Should have a valid MI RN License 
  • Should Have utilization management experience
  • Should have experience completing post-acute reviews for the inpatient rehab, skilled nursing facility settings previously
  • The candidate should be well versed in coordination of care activities along with discharge planning which is a plus for this role in ensuring members are transitioned safely following care.
  • In addition, the candidate should have knowledge of post-acute InterQual criteria that is utilized in this role.
Requirements:
  • Demonstrated clinical knowledge and experience relative to patient care and health care delivery processes.
  • One year health insurance plan experience or managed care environment preferred. Registered Nurse with current unrestricted Michigan Registered Nurse license required.
  • Certification in Case Management may be preferred based upon designated department assignment.
  • Above average computer skills 
  • linical experience in ICU, ER, or medical surgical unit preferred. .

Required profile

Experience

Spoken language(s):
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